1. Canadian disability policy: trends, reforms & implications for rehabilitation Michael J. Prince Lansdowne Professor of Social Policy University of Victoria “Celebrate Research Week” UBC Medical Student and Alumni Centre March 12, 2008

2. 2 My objectives today  To look at recent trends in Canadian context of personal supports and income for persons with disabilities  To identify Canadian policy developments and reform proposals  To raise implications for rehabilitation

3. 3 Disability-related supports  Aids and devices, medications  Assistance with activities of daily living  Supports within school  Workplace supports and job accommodations  Household adaptations/special features  Supports related to transportation, leisure activities  Community infrastructure

4. 4 Profile of need for supports  About 2 million Canadian adults lack one or more of the disability supports they need.  Half of children with disabilities who need specialized aids do not have all the aids they require.  Families supporting a family member with a disability have lower household incomes than other families. PALS, 2001

5. 5 Gaps in meeting needs for supports  Main reason for unmet needs of disability-related supports in Canada is cost concerns  This costs concern is especially prevalent for people with severe disabilities  A second reason for unmet needs is the lack of information on availability

6. 6 Demand for supports will only grow  Aging population of Canada  Pressures on smaller families  Public expectations for flexible, available, accountable services  Further deinstitutionalization  Labour market needs for skilled people

7. 7 Advocacy style on supports  Disability organizations frequently target the federal government for action on disability-related supports  Ottawa has been resistant to these claims for federal involvement  Even less likely now under Harper’s “open federalism” approach  Need to direct greater attention to provincial/territorial public sectors

8. 8 A five-point plan for reforming disability supports 1. Providing information – single access 2. Easing access to supports – review eligibility rules 3. Improving delivery of programs – consolidate programs, fill gaps 4. Developing citizen-centred – more individualized funding, peer support 5. Changing the broader context – legislation for accessibility Sherri Torjman, “Five –Point Plan for Reforming Disability Supports” (2007) at www.caledoninst.org www.caledoninst.org

9. 9 This plan as a set of ideas  Focus on provincial/territorial levels; not waiting for Ottawa  No new major public investments are required; some actions now  The five elements range from the most modest (information) to more ambitious (legislation on accessibility)  Can emphasize technical aids and devices; personal services; or environmental changes

10. 10 Large-scale reform ideas on disability supports  Involve federal/provincial/territorial action  Various devices available in principle: –Earmark funds through Canada Social Transfer –New Personal Supports Fund –Re-investment strategy linked with new federal basic income program

11. 11 Prospects for these large- scale reforms?  Harper government’s declared intention to limit the use of the federal spending power in areas of exclusive provincial jurisdiction, suggests that many of these large-scale reform ideas are not politically acceptable  But some options remain feasible

12. 12 Federal disability-related income programs as of 2002  Attendant Care Deduction  Canada Study Grant  CPP Disability Benefits  Caregiver Credit  Child Tax Benefit  Disability Tax Credit  EI Sickness Benefit  GST Credit  Infirm Dependant Credit  Medical Expense Tax Credit  Refundable Medical Expense Supplement  Veterans Pensions and War Allowances

13. 13 Additional federal disability-related income programs as of 2007  Canada Access Grants for college and university students  Child Disability Benefit  Children’s Fitness Tax Credit  Child Tax Credit  Disability Supports Deduction (replaces Attendant Care Deduction)  EI Compassionate Benefit  Registered Disability Savings Plan  New Veterans Charter with Disability Awards and Allowances  Working Income Tax Benefit and Disability Supplement

14. 14 Changes to existing federal income programs  Increases in maximum amounts: Child Disability Benefit  Extended scope of allowable expenses: Disability Tax Credit  Restricted coverage: Employment Insurance  Streamlined access: Old Age Security  Eased contribution requirements: CPP Disability for long-time workers  Strengthened penalty provisions for fraud: OAS and CPP

15. 15 Still other new federal income benefits  Apprenticeship Job Creation Tax Credit  Canada Employment Credit  Full Exemption of Postsecondary scholarships and bursaries  Tax Credit for Public Transit Passes  Textbook Tax Credit  Trades people’s Tool Expenses Deduction

16. 16 Declines in welfare incomes for persons with a disability, 1997-2005 NL - $1,327 -12.0 % -12.0 % PEI-1,921-19.2 NS-1,525-14.6 NB-124-1.5 QUE-137-1.3 ONT-1,855-13.3 MAN-1-132-11.6 SASK-541-5.7 ALTA-215-2.7 BC-693-6.1

17. 17 Deepening benefit inadequacy and financial insecurity  From 1997 to 2005, welfare incomes for a single person with a disability fell in all 10 provinces  In half the provinces, substantial declines of between 12% to 19% in the real value of social assistance  In 7 provinces, the 2005 welfare incomes for persons with a disability was the lowest level since 1986 when data were first collected by National Council of Welfare  For most provinces, the year of highest welfare benefit levels for persons with disabilities was in the early 1990s

18. 18 National Action Plan on Disability: “End Exclusion 2007” Four areas identified:  Investments in disability related supports  Initiatives to alleviate poverty  Measures to increase access to labour force  Initiatives to promote access, inclusion and full citizenship

19. 19 Conclusions  Recent pattern of numerous, separate add-ons is problematic  Need for policy mix of tax measures, income benefits, legislation, information, and services  Expanding supply of supports linked with improving income benefits and fostering labour force inclusion and community living

20. 20 Conclusions  Collaboration required  Federal Government take the lead on income security for Canadians with disabilities  Provincial /Territorial Governments lead for disability-related services and supports  Engagement by rehabilitation field, and other social care professions is crucial in these policy developments  Voice of families and individuals living with disabilities must be heard and respected